housefandomcom-20200223-history
Vicodin
via Wikipedia]]Vicodin is a common brand name for Hydrocodone/paracetamol (also known as hydrocodone/acetaminophen, hydrocodone/APAP or under other brand names such as Lortab '''or '''Norco) is a combination narcotic analgesic drug consisting of hydrocodone and paracetamol. It is indicated for relief of moderate to moderately severe pain of acute, chronic, or post-operative types. It is also used as a cough suppressant. Side effects Common side effects of Vicodin are common to all narcotic analgesics and include nausea, vomiting, constipation, and dry mouth. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash. The U.S. DEA classifies Vicodin as a schedule III drug - a low to moderate risk of physical dependence, but a high risk of psychological dependence. It is considered to be less of a risk than codeine or morphine. Vicodin poses some danger of overdose. In 2011, 37 deaths and over 30,000 incidents were reported to poison control centers from accidental use of the drug. Non-medicinal use of the drug accounted for over 82,000 emergency room visits. Of those visits, 372 resulted in the death of the patient and 118 were directly tied to the drug. Non-medical uses Like most other narcotics, Vicodin is abused for it's ability create a sense of euphoria. However, the body builds tolerance to its effects, which results in the abuser having to consistently increase the dose to get the same effect. Cesation of the drug leads to symptoms of withdrawal. About 23 million people over the age of 12 are estimated to have used it for non-medicinal purposes at least once during their lifetime. Because it does not face the restrictions of stronger more habit forming opiate based products, Vicodin is often a target for addicts who use such methods as fake and altered prescriptions, theft and illicit internet purchases. Addicts often combine it with alcohol as the risk of medicine interaction is lower with Vicodin than with other narcotics. Hydrocodone is abused for Hydrocodone diversion and abuse has escalated in recent years. In 2009 and 2010, hydrocodone was the second most frequently encountered opioid pharmaceutical in drug evidence submitted to U.S. federal, state and local forensic laboratories as reported by DEA’s National Forensic Laboratory Information System (NFLIS) and System to Retrieve Information from Drug Evidence (STRIDE). It is usually seized in pill form. It is also a major problem with high-school aged individuals. About 1.3% of 8th graders and 3.8% of 12th graders had used it for a non-medicinal purpose in a 2012 survey. However, abuse crosses all age groups and ethnic groups. Abuse of the drug also appears to be related to the perception that as a widely used prescription drug, it is somehow safer or more socially acceptable than other narcotics. Market In 2007, 99% of hydrocodone was consumed in the United States. Hydrocodone was the most commonly prescribed opiate in the United States as of 2012. 142 million prescriptions were dispensed in the US for hydrocodone combination products and hydrocodone/acetaminophen combination was the most common of those. Pharmacodynamics Hydrocodone: hydrocodone acts at μ-opioid receptors. Hydrocodone is metabolized to hydromorphone by the activity of cytochrome P450 2D6. Cytochrome 3A4 forms the substrate norhydrocodone. Note that this conversion is only somewhat responsible for the effects of hydrocodone. Hydrocodone passes through the blood–brain barrier because of its modifications. The brain is typically where the analgesic effects are being carried out. Many of side-effects of this drug are caused by the fact that it so readily crosses the blood–brain barrier. The half-life of hydrocodone is approximately 3.8 hrs. Paracetamol: the major active metabolites are sulphates and glucuronide conjugates. Its main mode of action is to inhibit the activity of the enzyme cyclooxygenase (COX). COX enzymes are necessary for the production of prostaglandins. Prostaglandins are a form of hormone (although rarely classified as such) that are indicated to be mediators of pain, fever, and inflammation. The half-life of paracetamol may be measured either by salivary or by plasma counts. Both measurements give a varying half-life between 1 and 4 hours. Peak levels are reached 40–60 minutes after ingestion. It has been proposed that paracetamol aids in the reduction of pain by increasing serotonergic neurotransmissions. It can be taken with or without food as desired. When taken with alcohol, it can intensify drowsiness. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Regulatory status United States Hydrocodone is habit-forming, and can lead to physical and psychological addiction; however, the potential for addiction varies from individual to individual depending on unique biological differences. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are considered Schedule II drugs. Those containing less than or equal to 15 mg per dosage unit in combination with acetaminophen or another non-controlled drug are called hydrocodone compounds and are considered Schedule III drugs. Hydrocodone is not available in pure form in the United States due to a separate regulation, and is always sold with an NSAID, acetaminophen or an antihistamine. The cough preparation Codiclear DH is the purest US hydrocodone item, containing guaifenesin and small amounts of ethanol as active ingredients. In Germany and elsewhere, hydrocodone is available as single-active-ingredient tablets as Dicodid (by analogy to the original manufacturer's other products Dilaudid and Dinarkon and others) available in 5 and 10 mg strengths. United Kingdom In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971. Vicodin is not licensed for use in the United Kingdom although the drug Co-Dydramol, which is a close equivalent is widely prescribed in its place. Politics Proposed U.S. ban On June 30, 2009, a FDA advisory panel voted by a narrow margin to advise the FDA to remove Vicodin and another painkiller, Percocet, from the market because of "a high likelihood of overdose from prescription narcotics and acetaminophen products". The panel cited concerns of liver damage from their acetaminophen component, which is also the main ingredient in commonly used nonprescription drugs such as Tylenol. Each year, acetaminophen overdose is linked to about 400 deaths and 42,000 hospitalizations. In January 2011, the FDA asked manufacturers of prescription combination products that contain acetaminophen to limit the amount of acetaminophen to no more than 325mg in each tablet or capsule. Manufacturers will have three years to limit the amount of acetaminophen in their prescription drug products to 325mg per dosage unit. The FDA also is requiring manufacturers to update labels of all prescription combination acetaminophen products to warn of the potential risk for severe liver injury. Manufacture The opioid constituent hydrocodone has the same basic structure as morphine but is metabolized by different enzymes. Hydrocodone, like oxycodone, is an intermediate-strength analgesic that has similar effects as morphine; hydrocodone is approximately twice as potent as morphine by mouth for acute use. The theory of using the mix comes from the idea that these drugs alleviate pain using different mechanisms and also that the adverse side-effects of each separate drug are reduced by using reduced dosages of both drugs in order to get the same analgesic effect. Both hydrocodone and paracetamol are white crystalline powders, which are then manufactured into tablet form. Manufacturers of hydrocodone include Abbott Laboratories (makers of trademark Vicodin), Amerisource Health Service Corp, Cardinal Health, Drx Pharmaceutical Consultants Inc, Eckerd Corp, Hospira Inc, Mallinckrodt Pharm. Quality Care, Pdrx Pharmaceuticals Inc, Physicians Total Care Inc, Rx Papoos Packaging Inc, and Watson Pharmaceuticals. Hydrocodone/paracetamol, in all strengths by all manufacturers, has been the #1 prescription filled in the US since 2002 with an estimated 136.7 million prescriptions filled in 2011. On the show Gregory House is known for abusing Vicodin. House acknowledges he has a dependency on Vicodin, agrees he is an addict, but refuses it being a problem as the drug allows him to function normally and do his job. See also *Vicoprofen, a mixture of Hydrocodone and ibuprofen *Percocet, a mixture of oxycodone and acetaminophen External links *Hydrocodone/paracetamol at Wikipedia - This article uses content from Wikipedia *Hydrocodone fact sheet at DEA *Vicodin U.S. Federal Regulations *Vicodin at NIH U.S. de:Vicodin es:Vicodin Category:Pharmaceuticals